Calcium carboxymethyl cellulose/quaternary ammonium chitosan self-gelling powder with good biocompatibility for wound hemostasis

In this study, a multifunctional self-gelling hemostatic powder (CQA) was designed using natural biomaterials by integrating the antioxidant and biocompatible properties of Aloe vera gel (AV) with the hemostatic efficacy of calcium carboxymethylcellulose (Ca-CMC) and the antibacterial activity of quaternary ammonium chitosan (QCS). The CQA powder rapidly absorbs moisture upon contact with blood, forming a physically sealing hydrogel network through electrostatic and hydrogen bonding interactions. In vitro evaluations revealed that the optimized formulation, CQA 0.3 , exhibits outstanding adsorption capacity, antioxidant activity, and biocompatibility. Compared to commercial chitosan-based hemostatic powder (CS), CQA 0.3 demonstrated significantly enhanced procoagulant performance, with a blood clotting index (BCI) of 8.48% versus 56.65% for CS, and promoted accelerated blood cell adhesion. In whole-blood coagulation assays, the CQA 0.3 group achieved rapid clotting within 180 s, while bleeding persisted in the CS group beyond 210 s. In practical hemorrhage models, CQA 0.3 reduced blood loss to 94.0 ± 8.7 mg, substantially lower than both the CQ group (225.7 ± 6.03 mg) and the CS group (292.7 ± 14.46 mg). These findings highlight the potential of CQA 0.3 as a safe, efficient, and adaptable hemostatic agent for emergency and clinical applications, combining rapid gelation, high biocompatibility, and excellent wound adaptability.